UCI vs Journal du Dimanche, Round 2

Sunday, 22 June 2014

Le Journal du Dimanche (JDD) has followed up its piece on last Sunday’s Affaire Froome with allegations that the UCI doesn’t have the proper process in place to issue Therapeutc Use Exemptions (TUE). The JDD quotes WADA boss David Howman as being “concerned” by this and how he’s “asked the UCI to rapidly fix the insufficiencies seen in this case“.

This is going to be a quick read because it’s a simple matter of whether the UCI or the JDD is telling the truth.

As… the JDD can reveal this Sunday, the UCI does not have the committee of international experts who are supposed to issue the TUEs (the TUEC), which nevertheless have long been requirements of the rules of the World Anti-Doping Agency! It’s solely down Dr Mario Zorzoli, the co-ordinator of the UCI’s medical committee, to grant these authorisations which can – as with Chris Froome – be a performance aid. WADA has therefore asked the UCI to fix this breakdown. We understand a TUEC will be formed this week, in time for the Tour de France.

In short the JDD says the UCI doesn’t have the committee specified in WADA’s guidelines.

2.1.1 The ADO must set up a network of physicians responsible for evaluating TUE applications. TUE Committees (TUECs) should include at least three physicians with experience in the care and treatment of athletes and a sound knowledge of clinical, sports and exercise medicine (see Article 6.1 of the International Standard for TUEs). The TUEC will be chaired by one of the member physicians.

Note an ADO is an “anti-doping organisation” and includes all bodies charged with upholding the WADA Code, including international federations like the UCI.

What the UCI says:
Which brings us to the UCI. It told us this time last week it did comply with the WADA Code and Guidelines. Twice. (my emphasis):

Christopher Froome’s TUE for oral use of glucocorticosteroids was granted on April 29, 2014 based on duly documented medical history and in compliance with the applicable UCI Regulations and the relevant WADA guidelines. The TUE was granted for a limited period, following the usual procedure…

…The UCI wishes to emphasise that under the applicable rules – which are consistent with the WADA Code and the WADA TUE Standard and Guidelines – any rider with the same symptoms as Christopher Froome would have received a similar TUE.

Summary
WADA says the UCI must have a formal committee of experts to review the granting of Therapeutic Use Exemptions. The UCI says it complies with the WADA Guidelines, suggesting the committee’s in place. But Le Journal du Dimanche says the UCI does not have a Therapeutic Use Exemption Committee and instead Dr Zorzoli has been acting alone, against WADA Guideline 2.1.1. Who is telling the truth, the UCI or the Journal du Dimanche?

Exactly. I had a look at other sports federations and several names who serves on their TUECs.

You could imagine secrecy to prevent lobbying but other sports don’t seem to worry about that. If if we were not to get the names the UCI could tell us how many people sit on the committee and since when.

According to your quote, the ADO must set up a “network” of physicians. Is this necessarily a fixed set of people, i.e. a committee in a narrower sense? To me this seems to be a typical example of sports regulation. Ambiguous.

Chapeau to JDD for calling this out! I’m willing to accept Cookson can’t fix all the problems with UCI instantly, but they need to address this and make every effort to be in compliance with WADA rules BEFORE they authorize things like this rather than after. Too often the team the fellow involved rides for seems to loudly oppose use of banned substances..but only AFTER their use by the team is exposed or their goals have been reached. Those who would accuse me of being a “hater” of this team should understand it’s what seems like a “Well, it’s not on the banned list, so we’ll keep quiet about it while exploiting its benefits…all part of our marginal gains strategy.” policy as much as my dislike for the Murdoch regime in general.

I agree with you about good on JDD for calling this out i wonder how many other cases there are out there like this one. By the way the problem isn’t Sky by the sounds of it, it is within the UCI for approving the request without going through the proper system set out by WADA. The fact that one person is responsible for the approval of TUE’s is a terrible system and need to be urgently amended

Walsh is in great danger of following the Kimmage path to somewhere the sun doesn’t shine. In his book relating to his time embedded with sky, Walsh was told openly and clearly that the team had applied for two TUEs in the previous fifteen months. Both were out of competition cases. The question which no one wants to address is ‘what have sky done that is not within the rules’ ?

this stinks of someone, somewhere, getting things disastrously wrong. Presumably somewhere along the line the buck will stop, but I personally would give Cookson the benefit of the doubt- presumably this set up has existed from before he took office. But now the spot light is on this issue it has to be dealt with in full and in the open.

The spotlight was on this issue before Cookson. This issue was one of the reasons he was elected. He promised transparency and an overhaul of anti-doping practices. Almost a year later, we see the same practices by the same people. Where is Cookson? He’s arguing with Kimmage on twitter and not addressing the issues in the JDD article. Not good.

Well, Cookson has been busy making nice with the IOC, getting cameras on bikes and more. (not joking) What that should tell the casual reader is that nothing has changed at the UCI since Armstrong was finally sanctioned despite numerous unsanctioned positives. The level of support of anti-doping in cycling has not changed.

To be clear and something that cannot be repeated enough, the UCI reports to no one. No TUE committee is no problem. It’s not WADA compliant, but no one has the authority to do anything to the UCI. WADA can only remark, “Yup. Not compliant.”

Moreover, the informal way the TUE was handled tells the world the federation STILL cares not one bit for anti-doping, favors riders, and (again) altering race outcomes of races with TUE’s.

I believe that the UCI reports to those who pay the bills, namely the race organizers (IOC, ASO, etc.). IIRC, WADA was set up by the IOC. Non-compliance to WADA requirements could leave the UCI out of some major sporting events and the corresponding revenue. Hence the need for Cookson to “make nice” with the IOC.

We know that race organizers like to have the stars in their races. How much influence do the organizers have with the UCI to get the stars? Could the organizers influence the TUE “committee” to get the rider he/she wants?

…”the federation STILL cares not one bit for anti-doping, favors riders, and (again) altering race outcomes of races with TUE’s.”

I believe the federation and race organizers care about these issues if they bring in revenue. The question is whether the generic fan will show up to see a Tour winner ride in the pack or seeing a TUE-enabled Tour winner win the race.

I believe that the UCI reports to those who pay the bills, namely the race organizers (IOC, ASO, etc.)

Not really. Cycling’s success at the Olympics is up to the UCI, not the IOC. The IOC simply provides guidelines/standards about how the events run. (not too long, not too many athletes, broadcast standards, etc.) And then they grant cycling time slots in the broadcast feed. It is a very clearly defined business relationship where the IOC is not interested in doing the UCI’s job.

ASO does not need the UCI. They simply do not want to be involved in the rules making/enforcing. Currently, it seems like they are in a more peaceful phase where ASO gets most of the revenue from WT events with ASO’s influence/control still rising.

Wow. So after the post-dated script for Lance, we are going to have a post-dated committee to save Froome, his team as well as the UCI… Wait, wait it will come! Just another lie to cover a lie….
Come to think of it, this is absolutely no surprise — all in the family one could say. Lets not forget Cookson’s very own son works for Sky — doing what besides being Cookson’s son? That’s not very clear… His job title is either absurdly vague or non-existent. Perhaps he’s being paid for nothing…Can you say conflict of interest? (It is an old trick — lets not start counting the number of children of Congressmen employed by big Pharma… Its enough to make you sick! Ha. Ha. Ha.)

Oli Cookson’s job is neither vague, nor non-existant and he is certainly not being paid for nothing. He is part of Sky’s logistics team and as a fluent Spanish speaker is a key liaison for the team’s Spanish and Columbian riders. He has had this job for about four years, so well before his father became head of the UCI.

The Oli Cookson conflict of interest is another topic I’ll return to during the week. The UCI has several obvious conflicts of interest (Igor Makarov on the board, the GCP promotion sideline etc) and these need to be managed formally and transparently, as opposed to the “trust us” stance. Like I say I’ll try to put some more thoughts on this in the week.

This is NOT a question about sky, they have just become the focus of the existing situation by simply doing what was required of them. The UCI have a ‘system’ in place, clearly poorly understood by many, which allows TUEs to be issued by a single person. It should not be difficult for the UCI to place the system into the public domain now that questions concerning its validity have been raised.
I do despair at the constant criticism from some quarters of the potential conflict of interest between Oliver and Brian Cookson. I think time will confirm that Brian Cookson is a man of principal and of his word. The two happen to be father and son, but are paid and serve different organizations in completely different roles.

People are slipping into old habits here at the first sign of trouble. As I understand, the medical commission reviews the TUEs submitted. You can see who is on the current UCI medical commission here: http://www.uci.ch/templates/UCI/UCI1/layout.asp?MenuId=MTI2ODc&LangId=1
Katharina Grimm, who is in charge of the TUE committee for WADA, is now on the UCI medical commission, which should make everyone feel safer.
There are other IFs who have their medical commission double as their TUEC. Much work has been done on the TUE issue internationally, and you can see one example of this here: http://www.coe.int/t/dg4/sport/Source/T-DO/T-DO_2010_03_EN_report_MPetrou.pdf
Zorzoli was in attendance.
I’m surprised by the reaction considering WADA is now backing the UCI. I guess everyone thinks WADA’s become dirty now?
On the other side of the coin, what if there were problems in the process which would have implicated Grimm, one of the key people at WADA? What about this phrase from the UCI’s website for TUEs (it also says in clear language TUEs are approved and reviewed by a committee),
“All TUE applications must be received by the UCI at least 21 days before medication is commenced.”
What does this mean? Froome’s quotes say they submitted for a TUE around the 27th or 28th, and it was issued the the 29th, the day Romandie started. So it this against the TUE rules then? Inner Ring? Anyone?

When was it disbanded? Did Azzam disband it after Cookson appointed him president of the medical commission? Was it disbanded previously? If Cookson knew as of March there was a problem with the TUE committee, was it corrected quickly? After finding this, I think the concerns about transparency are legitimate.

True! If they had come forward with a statement inclusive of this information, it might have resolved the ambiguity, and a strange media release meant to bully. The approach they took says there maybe something to hide. What are they hiding? It could be Azzam made changes to the commission without the knowledge of Cookson. It could be Cookson ignored the recommendations of iNado and didn’t implement the urgent fixes quick enough. It could be corners were cut because it was Froome.
I wouldn’t be surprised if Zorzoli himself leaked the information as he was uncomfortable with what was occurring. It wouldn’t be the first time he leaked information, as his prior leak helped implicate Armstrong.
Too bad Cookson just won’t admit they screwed up, sorry, we’re fixing it, and move on. Now it’s become a bigger issue with hints of Verbruggenisms.

Except that Zorzoli isn’t one of the committee? His name is on the page but he’s in addition to the 1 chair/4members. It could be that TUEC is set up using those people, but I don’t think this changes the position that the UCI should issue some clarity and have the sense to APOLOGISE if they’ve made a mistake.

Would that mistake invalidate the Tour Of Romandie? Cue CAS and a 20 month delay.

Go and ask UKAD for an update. It has been totally in their hands since the UCI’s decision last Dec and request to BC to deal with the sanction, when BC immediately passed it over to UKAD as per the agreement between UK sports governing bodies and UKAD. in place to prevent conflict of interest.

The pool of professionals that make up CAS boards are a small and endlessly conflicted group. The lawyers that make up CAS boards frequently and simultaneously work for sports federations, and defend athletes at other CAS arbitrations.

It might be another area of the sport that you might want to write an article about at some point.

I have to either interpret legislation or write legally enforceable conditions all the time with my job (but IANAL). I am always told be people who are lawyers, however, that “should” doesn’t mean “must”. That is, “should include at least three physicians” is just a recommendation.

Just ask Cookson on his twitter feed, (actually I’ve done that – asked him if the medical committee is resposible for TUE’s) plus he normally reads a lot of web stuff – he is at least up to speed on how we the fans air our views on the way the sport is run. For me, Sky have a process to follow, they did – just like any other team would have done, the problem was that it was for Froome (and it appears that is still causing suspicion) therefore high profile. The UCI are not perfect, but it appears now they are trying to sort themselves out, unfortunately its just like stopping a large ship at sea and then turning it around to point in the other direction… a long and drawn out process…

Sky seem to have followed the rules. This is more a matter for the UCI, they told us (twice) they followed the WADA Guidelines and now it appears they don’t. I stress appears, they can show otherwise.

This can all be fixed and turned around but it’s not good if they pretend to do things in press releases they’re not. If there’s no committee they should have said “yes, our doctor has been handling this but since our audit in the spring we’re moving towards a committee to resolve this”, ie selling the reform.

This story isn’t going away, and Walsh is now wading in with his comments in the Sunday Times yesterday.

I’ve a couple of questions that are slightly off topic – if Froome had been given the treatment and had pulled out of competition (as per the MPCC rules even though Team Sky are not a member, but this seems to be one of the “problems” with the story), would he still have had to apply for a TUE in case he was tested out of competition (thus making the whole MPCC thing irrelevant regarding the TUE)?

Or would this treatment have been denied to him completely if he were in a MPCC team, even if it was the correct treatment to have?

I didn’t realise that you could get away with testing positive for certain prohibited substances out of competition – presumably only ones that have short term gains and can be easily explained away with medical use as the reason?

Sam is wrong, TUEs are for any use of banned substances for medical purposes at any time, not just in-competition use. So you can’t get away with taking a banned substance out of competion on medical grounds unless you have a TUE.

On the MPCC point, there seems to be a lot of confusion as to what the MPCC rules say, including in what I think is a highly misleading article on cyclingnews today (http://www.cyclingnews.com/features/team-sky-no-medicine-for-regret). What the MPCC rules actually say is:
“Local corticosteroid injections must be validated by the physician in charge of the team, which prescribe mandatory minimum eight days off work and competition.” This reflects the UCI rule article 13.1.065 which states that:
“In case of a local injection of glucocorticosteroids, which is subject also to the Anti-Doping Rules and the Prohibited List, the rider must rest and is prevented from competing for 8 days.”
Note that Froome’s TUE was to take glucocorticosteroids orally, not by injection. So neither the MPCC rules or the UCI rules required Froome to be pulled from competition.

Why have the TUE at all? Injury, attrition, and sickness are a part of the weeding out to award the final champion. On the flip-side, ANY use of substances to bring performance back up to a ‘normal’ level is relative. Anyone not engaging in the acquisition of TUE’s is not doing all within the rules to succeed, therefore unprofessional in today’s system. The biggest problem for the sport today is the perception of doping held by the public. Why not just eliminate everything? It worked with ‘no needles’, right?

Across all sports? Incorporate it into a future edition of the WADA Code?

Hardly any other sports governing bodies fell in line with the UCI on a needles ban. Struggling to think of one, actually.. And they won’t – unless they’re forced to by the WADA code. And to get to that point, the majority of other sports governing bodies will need to resist battling it to make it through the laborious Code consultation process.

All the nitpicking on the rules and committees aside, is there someone knowledgeable reading this who can tell me if the specific substance this TUE was for would be considered performance-enhancing in a healthy individual. Of course it is performance-enhancing if it cures or alleviates symptoms of a condition, but otherwise? I thought some types of steroids are used for boosting muscles and others are not but they are banned mainly because they are hard to distinguish from the muscle-boosting types and would lead to complicated debates if steroids are found in urine, but maybe I’m all wrong here.

The answer to your question is probably yes… but this shouldn’t be about the individual case or one race. For me at least it should be that the UCI has a firm procedure in place that matches the WADA Guidelines so that we’re not left wondering if this is OK or not.

Part of the problem here is that we’re in the realm of WADA’s Guidelines, not its Code. The Code is binding, you must comply with all of it. Guidelines are not: you can be consistent with Guidelines even if you don’t follow them to the letter.

Looks like the UCI have adopted their own interpretation of the TUE Committee Guidelines by having a Dr 1st, Committee review later process, rather than a Committee 1st, process. Is Zorzoli a permanent member of UCI staff? I can see how you might do things differently if you had an in-house Dr, rather than having to constitute a committee of consultants. Not sure if this is what’s happened here, or if they just overlooked the guidelines.

For instance, see the last paras of the introduction to the TUE Guidelines:

“As a model for best practice, these guidelines are not mandatory and have no legal status. Only the International Standard for TUEs is mandatory and, in the event of any differences or ambiguities between the present guidelines and the International Standard for TUEs, the latter shall prevail.

ADOs are free to decide how to incorporate these guidelines into their own rules and procedures. They may be incorporated in full or in part, and may be amended or reworded to best fit the requirements of the ADO.”

Agreed. But let’s note two things. Here’s 2.1.1 of the WADA TUE Guidelines again, “The ADO must set up a network of physicians responsible for evaluating TUE applications”, the “must” is noticeable. Then the UCI says twice it complied with the guidelines… only for the anti-doping audit as highlighted above by Javi showed it doesn’t comply on the TUEC issue.

This should all be a small issue but it’s a sensitive topic with a top rider, the biggest team, banned substances, Dr Zorzoli, the UCI and so on – each are sensitive ingredients.

The World Anti-Doping Program was developed and implemented to harmonize anti-doping policies and regulations within sport organizations and among governments.

SPORT & ANTI-DOPING ORGANIZATIONS

In this section, sport and anti-doping organizations can find information about the three levels of the World Anti-Doping Program :
1. World Anti-Doping Code (Code)
2. International Standards
3. Models of Best Practice and Guidelines

Levels 1 (Code) and 2 (International Standards) are mandatory for all Code signatories.
Level 3 (Models of Best Practice and Guidelines, including Model Rules) is recommended by WADA, and is made available to Code signatories upon request but is not mandatory.

The World Anti-Doping Code International Standard for Therapeutic Use Exemptions (TUE) is a Level 2 mandatory International Standard developed as part of the World Anti-Doping Program.

p.14 :

PART TWO: STANDARDS FOR GRANTING THERAPEUTIC USE EXEMPTIONS

4.0 Criteria for Granting a Therapeutic Use Exemption

[…] An application for a TUE will be reviewed by a Therapeutic Use Exemption Committee (TUEC). The TUEC will be appointed by an Anti-Doping Organization.

p.15 :

4.3
An application for a TUE will not be considered for retroactive approval except in cases where:

a. Emergency treatment or treatment of an acute medical condition was necessary, or

b. Due to exceptional circumstances, there was insufficient time or opportunity for an applicant to submit, or a TUEC to consider, an application prior to Doping Control.

p.16 :

6.0 Therapeutic Use Exemption Committees (TUECs)

TUECs shall be constituted and act in accordance with the following guidelines:

6.1
TUECs should include at least three (3) physicians with experience in the care and treatment of Athletes and a sound knowledge of clinical, sports and exercise medicine. In order to ensure a level of independence of decisions, the majority of the members of any TUEC should be free of conflicts of interest or political responsibility in the Anti-Doping Organization . All members of a TUEC will sign a conflict of interest agreement. In applications involving Athletes with disabilities, at least one TUEC member shall possess specific experience with the care and treatment of Athletes with disabilities.
6.2
TUECs may seek whatever medical or scientific expertise they deem appropriate in reviewing the circumstances of any application for a TUE.
6.3
The WADA TUEC shall be composed following the criteria set out in Article 6.1. The WADA TUEC is established to review the granting or denial of TUEs for International-Level Athletes, Athletes entered in an International event as described under 7.1(b), or Athletes in their National Anti-Doping Organization’s Registered Testing Pool as set forth in Article 4.4 of the Code. In normal circumstances, the WADA TUEC shall render a decision within 30 days of receipt of all requested information.

—-

Thoughts:
1. It would seem that not having a TUEC is not in compliance with WADA ISTUE.
2. Assuming the UCI does not have a TUEC, taking the better part of 4 months to re-establish a TUEC seems rather long (would have thought that 1-2 months would have sufficed) especially as not having one would appear to be a rather obvious thing and one wouldn’t need to wait for the conclusion of an audit to go about re-establishing one. If that is the case, it does not bode well for Cookson’s tenure.
3. Was wondering if it was possible for Dr. Zorzoli to somehow get TUEs approved through official or unofficial routes to the WADA TUEC. Something of the sort could explain why WADA initially backed the UCI by stating that the Froome TUE was conducted in accordance with ISTUE.

So are we just talking about Romandie here or would these TUE’s have been granted for the past two TdF’s as well? I realize we are discussing slightly different issues here, one being whether proper protocol for the issuance of a TUE is being followed – but the bigger question is whether in-competition use of otherwise banned substances confers an advantage not available to other riders without similar medical conditions.
I ask because from reading your comments it seems like the TUE disclosure this spring came as a leak from an insider, not from a normal publicly visible process.

TUEs could have been applied for and granted for ANY rider during any race, not just the last 2 years but since TUEs have been in place across sports – from the Tour to the Giro and Vuelta, from TDU to Tour of Beijing.

And not just cycling. You’ll have watched any sporting event during the London Olympics, for example, and a HEAP of athletes would have been competing with TUEs.

We should keep in mind that the idea of TUEs is to enable athletes with a genuine medical complaint, to compete.

TUEs are not publicised because they are treated as personal confidential information.

Exactly. Froome is getting a bashing because the information that he had a TUE was leaked but we have no idea whether any other rider in Romandie or any other race was/is competing with a TUE as it isn’t public info. It is likely that plenty of riders have competed with TUEs given that it isn’t against either the UCI or MPCC rules (except in the case of injections), although hopefully not as many as suggested in this article from 2006 – http://www.cyclingnews.com/news/13-positives-at-tour-but-12-had-exemption

From the article you tagged above, (referring to the 2006 TdF), we get the following:
“Sixty percent of the 105 controlled riders (those that were tested) had TUE’s […], which raises serious doubts and leaves one to think that they can be used to hide doping practices.”

As I have swung away from my former naivete in regards to this whole issue, I can’t help remembering the quote from the lead character of my beloved favourite teenage movie:

“Everybody cheats. I just didn’t know.” (Breaking Away, 1979)

I want to be proved wrong, but after all the admissions over the past couple years I will be on the side of the skeptics.

One of my fundamental problems with all of this is that someone who legitimately needs steroids for asthma shouldn’t be anywhere near a bike. Asthmatics who are given steroids out of hospital are ones you are trying to stop getting admitted not win a bike race!